• Title/Summary/Keyword: ED

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Errors of Death Certificate for Poisoning Related Death (중독 관련 사망에서의 사망진단서 오류)

  • Park, Chan Hyeok;Kim, Sun Hyu
    • Journal of The Korean Society of Clinical Toxicology
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    • v.18 no.1
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    • pp.11-17
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    • 2020
  • Purpose: This study examines errors in death certificates (DCs) issued to cases of poisoning. Methods: DCs issued in poisoning cases were retrospectively reviewed. Errors in the DC were classified as major and minor errors, and were evaluated in accordance with their impact on the process of selecting the cause of death (COD). Results: A total of 79 DCs were evaluated; 43 (54.4%) DCs were issued in the emergency department (ED), and 36 (45.6%) DCs were issued outside the ED. The average major and minor errors per DC were determined to be 0.4 and 3.3, respectively. Moreover, an average of 3.0 errors were discovered in DCs issued at the ED, and 4.4 errors in DCs issued outside the ED. The most common major errors were incorrect manner of death (11.4%, 9/79), followed by unacceptable COD (7.6%, 6/79), and the mode of dying as an underlying COD (5.1%, 4/79). The common minor errors most frequently encountered were incorrect time interval (86.1%, 68/79), followed by incorrect other significant conditions (73.4%, 58/79), and no record for date of onset (62.0%, 49/79). Conclusion: Our results indicate that the total numbers of major errors, minor errors and cases of misjudged cause of death were greater in DCs issued outside the ED than in DCs issued at the ED. The most frequently quoted major error of DCs related to poisoning was determined to be the incorrect manner of death.

Premature Ejaculation and Erectile Dysfunction in Iranian Prostate Cancer Patients

  • Lin, Chung-Ying;Burri, Andrea;Pakpour, Amir H
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.1961-1966
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    • 2016
  • Background: To investigate the prevalence of premature ejaculation (PE) and erectile dysfunction (ED) in a sample of patients with prostate cancer and to determine the utility of the previously suggested cutoffs of the Premature Ejaculation Diagnostic Tool (PEDT) for the diagnosis of PE and that of International Index of Erectile Function (IIEF-5) for ED. Materials and Methods: A total of 1,202 men with prostate cancer were invited from urology clinics at the universities of Iran, Tehran, Qazvin, Ahvaz, Guilan and Tabriz. Clinical characteristics were collected through medical records. PE and ED diagnoses were made by trained urologists. In addition to the clinical diagnoses, PE and ED were measured through self-report using the PEDT and the IIEF-5. Questionnaire cutoff scores were determined using receiver operating characteristic (ROC) curves and confirmed by predictive ability using logistic regression. Results: The prevalence of PE was 63.7% and that of ED was 66.2%. Prevalences of PE decreased and that of ED increased with advanced TNM stages. According to ROC, the suggested cutoff for the PEDT to diagnose a PE was ${\geq}11$ (sensitivity=0.988, 1-specificity=0.084, and predictive ability=0.914) and ${\leq}17$ for the IIEF-5 (sensitivity=0.966, 1-specificity=0.031, and predictive ability=0.967). Conclusions: Prevalence of sexual problems was high in prostate cancer patients in Iran, therefore oncologists should take into account these potential problems when deciding on treatment modalities.

Cancer Patients Are at High Risk of Mortality if Presenting with Sepsis at an Emergency Department

  • Prachanukool, Thidathit;Tangkulpanich, Panvilai;Paosaree, Possawee;Sawanyawisuth, Kittisak;Sitthichanbuncha, Yuwares
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.7
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    • pp.3423-3426
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    • 2016
  • Background: Sepsis is an emergency condition with high mortality and morbidity rate. There are limited data on the association of cancer as a risk factor for mortality in sepsis patients in the emergency department (ED). Materials and Methods: This retrospective study was conducted at the ED, Faculty of Medicine, Ramathibodi Hospital, Bangkok, Thailand. The study period was between January 1st and December $31^{st}$, 2014. The inclusion criteria were as follows: adult patients over 15 years of age who presented at the ED with suspicion of sepsis, received treatment at the ED, and whose blood culture was found to be positive. Clinical data were recorded from medical records including the Mortality in Emergency Department Sepsis score (MEDS score). The primary outcome of this study was mortality at one month. Multivariate logistic regression analysis was used to identify independent factors associated with death. Results: During the study period, there were 775 eligible patients. The two most common pathogens identified from blood cultures were Staphylococcus aureus (193 patients; 24.9%) and Escherichia coli (158 patients; 20.4%). At one month after presenting at the ED, 110 patients (14.2%) had died. There were four significant factors for death, having cancer, being on an endotracheal tube, initial diagnosis of bacteremia, and high MED scores. Having cancer had an adjusted OR of 2.12 (95% CI of 1.29, 3.47). Conclusions: Cancer patients have double the risk of mortality if presenting with sepsis at the ED.

Application of a Pilot-Scale Electrodialysis System for Groundwater Polluted with Arsenic and Manganese (파일롯 규모 전기투석 막여과 시스템을 이용한 비소와 망간오염 지하수 처리)

  • Choi, Su Young;Kwon, Min Wook;Park, Ki Young;Cha, Ho Young;Kim, Hee Jun;Kweon, Ji Hyang
    • Journal of Korean Society on Water Environment
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    • v.33 no.3
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    • pp.334-340
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    • 2017
  • A pilot-scale electrodialysis system was designed and constructed to treat groundwater polluted with arsenic and manganese. Synthetic groundwater, in which some amount of arsenic and manganese was added to make 500 mg/L of Mn and $50{\mu}g/L$ of As, was used as a feed for the ED system. The limiting current density, linear water velocity, applied voltage, and membrane surface area were investigated to obtain efficient and economic operation of the ED system. The linear water velocity was increased 0.74 cm/s to 11 cm/s based on evaluation of limiting current density. The water quality of diluate for 85 minutes of operation was satisfied with water quality criteria for drinking water using the ED system with 14 pairs of ion exchange membranes. The increased membrane pairs to 21 and 42 pairs were very effective to reduce conductivities of the diluate. The operation cost of the ED system was assessed using specific energy consumption, which was $1.065{\sim}1.2kWh/m^3$. Considering low salt concentrations of the groundwater, improvement of the ED system are required to increase current utilization and to apply low voltage while the ED system was applicable to produce drinking water.

Fully Distributed Economic Dispatching Methods Based on Alternating Direction Multiplier Method

  • Yang, Linfeng;Zhang, Tingting;Chen, Guo;Zhang, Zhenrong;Luo, Jiangyao;Pan, Shanshan
    • Journal of Electrical Engineering and Technology
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    • v.13 no.5
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    • pp.1778-1790
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    • 2018
  • Based on the requirements and characteristics of multi-zone autonomous decision-making in modern power system, fully distributed computing methods are needed to optimize the economic dispatch (ED) problem coordination of multi-regional power system on the basis of constructing decomposition and interaction mechanism. In this paper, four fully distributed methods based on alternating direction method of multipliers (ADMM) are used for solving the ED problem in distributed manner. By duplicating variables, the 2-block classical ADMM can be directly used to solve ED problem fully distributed. The second method is employing ADMM to solve the dual problem of ED in fully distributed manner. N-block methods based on ADMM including Alternating Direction Method with Gaussian back substitution (ADM_G) and Exchange ADMM (E_ADMM) are employed also. These two methods all can solve ED problem in distributed manner. However, the former one cannot be carried out in parallel. In this paper, four fully distributed methods solve the ED problem in distributed collaborative manner. And we also discussed the difference of four algorithms from the aspects of algorithm convergence, calculation speed and parameter change. Some simulation results are reported to test the performance of these distributed algorithms in serial and parallel.

Differences in youngest-old, middle-old, and oldest-old patients who visit the emergency department

  • Lee, Sang Bum;Oh, Jae Hun;Park, Jeong Ho;Choi, Seung Pill;Wee, Jung Hee
    • Clinical and Experimental Emergency Medicine
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    • v.5 no.4
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    • pp.249-255
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    • 2018
  • Objective As aging progresses, clinical characteristics of elderly patients in the emergency department (ED) vary by age. We aimed to study differences among elderly patients in the ED by age group. Methods For 2 years, patients aged 65 and older were enrolled in the study and classified into three groups: youngest-old, ages 65 to 74 years; middle-old, 75 to 84 years; and oldest-old, ${\geq}85years$. Participants' sex, reason for ED visit, transfer from another hospital, results of treatment, type of admission, admission department and length of stay were recorded. Results During the study period, a total 64,287 patients visited the ED; 11,236 (17.5%) were aged 65 and older, of whom 14.4% were 85 and older. With increased age, the female ratio (51.5% vs. 54.9% vs. 69.1%, P<0.001), medical causes (79.5% vs. 81.3% vs. 81.7%, P=0.045), and admission rate (35.3% vs. 42.8% vs. 48.5%, P<0.001) increased. Admissions to internal medicine (57.5% vs. 59.3% vs. 64.7%, P<0.001) and orthopedic surgery (8.5% vs. 11.6% vs. 13.8%, P<0.001) also increased. The ratio of admission to intensive care unit showed no statistical significance (P=0.545). Patients over age 85 years had longer stays in the ED (330.9 vs. 378.9 vs. 407.2 minutes, P<0.001), were discharged home less (84.4% vs. 78.9% vs. 71.5%, P<0.001), and died more frequently (6.3% vs. 10.4% vs. 13.0%, P<0.001). Conclusion With increased age, the proportion of female patients and medical causes increased. Rates of admission and death increased with age and older patients had longer ED and hospital stays.

Comparison of the characteristics of patient who cancel after presentation to an emergency department by 119 ambulance (119 구급차를 통해 응급의료센터에 내원한 접수취소 환자들의 특성 비교)

  • Yong-Joon Kim;Kyoung-Youl Lee
    • The Korean Journal of Emergency Medical Services
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    • v.27 no.3
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    • pp.47-58
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    • 2023
  • Purpose: The purpose of this study was to analyze the characteristics of patients who canceled their ED visits and to determine the factors that influence ED cancellation. Methods: Retrospective study that analyzed data from the electronic medical records(EMR) and Prehospital Care Reports(PCRs) of 305 patients who cancelled their appointments at a single emergency medical center over a six-month period from October 12, 2022, to April 12, 2023. Results: ED cancellations were 2.287 times higher if the patient presented to the ambulance after outpatient hours(09:00~17:00) (p=.007), and ED cancellations were 3.712 times higher if the patient presented to the ambulance under the influence of alcohol(p=.011). For patients' symptoms, medical diseases were associated with a 1.965 times increase in cancelled ED visits compared to other modes of transport (p=.005), while mental and chronic diseases were associated with a 67.3% decrease in cancelled ED visits compared to other modes of transport (OR=0.327, CI=[0.130-0.822], p=.018). symptomatic improvement was associated with a 2.482 times increase in presentations to a 119 ambulance compared to delayed waiting time(p=.022). Conclusion: Emergency medical centers should consider improving the legal system, such as increasing emergency medical care fees, to reduce the number of patients who cancel their appointments.

Pearls and Potential Pitfalls for Correct Diagnosis of Ovarian Cystadenofibroma in MRI: A Pictorial Essay

  • Giacomo Avesani;Gianluca Caliolo;Benedetta Gui;Federica Petta;Camilla Panico;Viviana La Manna;Francesca Moro;Antonia Carla Testa;Giovanni Scambia;Riccardo Manfredi
    • Korean Journal of Radiology
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    • v.22 no.11
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    • pp.1809-1821
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    • 2021
  • Ovarian cystadenofibroma is a benign ovarian tumor that is characterized by a consistent percentage of masses, which remain indeterminate in ultrasonography and require magnetic resonance (MR) investigation; they may mimic borderline or malignant lesions. Three main morphologic patterns, resembling different ovarian neoplasms, can be identified in cystadenofibromas: multilocular solid lesions, unilocular cystic lesions with parietal thickening, and purely cystic masses. However, a cystoadenofibroma has typical features, such as T2-weighted hypointensity associated with no restrictions in diffusion-weighted imaging (the so-called "dark-dark appearance") and progressive post-contrast enhancement (type I perfusion curve). The purpose of this study was to review the features of ovarian cystadenofibromas in MR imaging and to suggest pearls and pitfalls regarding their correct diagnosis.

Changes in the characteristics of acute carbon monoxide poisoning patients who visited the emergency department during the COVID-19 pandemic (코로나바이러스감염증-19 대유행 이후 응급실로 내원한 급성 일산화탄소 중독 환자의 특성 변화)

  • Jun bo Sim;Tae kyu Ahn;Hyun Kim
    • Journal of The Korean Society of Clinical Toxicology
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    • v.21 no.2
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    • pp.108-116
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    • 2023
  • Purpose: This study investigated the differences between patients with acute carbon monoxide (CO) poisoning who visited the emergency department (ED) before and during the coronavirus disease 2019 (COVID-19) pandemic. Methods: This was a single-center retrospective observational study. Patients with CO poisoning who visited the ED during the period from February 2020 to January 2023 were classified as the COVID-19 pandemic group, and those from February 2019 to January 2020 were classified as the non-pandemic group. Patients' medical records were reviewed, their demographic and clinical characteristics were compared, and the length of stay in ED was checked. The time from admission to the ED to the start of hyperbaric oxygenation (HBO) was defined as the door-to-HBO time, and this parameter was compared between both groups. Results: In total, 672 patients were included in this study. The proportion of intentional poisoning was significantly higher in the COVID-19 pandemic group than in the non-pandemic group (p=0.028). The proportion of intentional poisoning significantly increased in the 20- to 29-year-old age group during the COVID-19 pandemic (p<0.001). In addition, it took longer to initiate HBO in the COVID-19 pandemic group than in the non-pandemic group (p=0.001). Conclusion: These findings suggest that pandemics of infectious diseases, such as COVID-19, increase the proportion of intentional CO poisoning, and it may take longer to initiate HBO after visiting the ED. Efforts will be needed to decrease intentional CO poisoning and length of stay in ED.

Analysis of the Genotype Distribution in Cattle Breeds Using a Double Mismatched Primer Set that Discriminates the MC1R Dominant Black Allele (소 MC1R 우성흑모색 대립인자를 구분하는 변형 프라이머를 이용한 소 품종들의 유전자형 분포 분석)

  • Han, Sang-Hyun;Kim, Young-Hoon;Cho, In-Cheol;Jang, Byoung-Gui;Ko, Moon-Suck;Jung, Ha-Yeon;Lee, Sung-Soo
    • Journal of Animal Science and Technology
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    • v.50 no.5
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    • pp.633-640
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    • 2008
  • With a double mismatch primer set designed for amplifying the modified DNA sequence fragments, bovine melanocortin-1 receptor(MC1R) gene encoded in Extension locus which plays a critical role in coat color development was analyzed using polymerase chain reaction mediated restriction fragment length polymorphism(PCR-RFLP). Amplified PCR fragments were successfully discriminated with combining the MspI- and AluI-RFLP into three major alleles(ED, E+, and e), directly related to bovine coat color phenotypes. The genotyping results showed that Jeju black cattle contained three MC1R alleles, but yellowish-red colored Hanwoo and bridle colored Korean Brindle cattle did not contained the dominant black allele ED. However, two dominant black-colored cattle breeds, Holstein and Angus, contained the ED allele over 96% in frequency. Hanwoo×Holstein F1 and Hanwoo×Angus F1 crossbred calves showed ED/e MC1R genotypes, and uniformly black coat color. the results suggested that this MC1R genotyping method be useful in allele discrimination for bovine MC1R gene which used for breed classification and characterization, as one of the important genetic markers, using combination of MspI- and AluI-RFLP for modified PCR product amplified with a newly designed double mismatch primer set.